PDF(Pubmed)
Abstract：
Background: Tracheal intubation in the Sellick and Trendelenburg position (ST position) can prevent pulmonary aspiration but increase the difficulty of tracheal intubation. We compared tracheal intubation using video and direct laryngoscopy in the ST position with direct laryngoscopy in the supine sniffing position to evaluate the overall intubation performance. Methods: One hundred and twenty patients were randomly assigned to three groups: direct laryngoscope in the supine sniffing position (control), direct laryngoscope in the ST position (ST direct), and video laryngoscope in the ST position (ST video). The primary outcome was the intubation time; secondary outcomes included the first attempt success rate of tracheal intubation, intubation difficulty scale score, operator\'s subjective assessment of intubation difficulty, and modified Cormack-Lehane grades. Results: The median intubation times were greater in the ST direct (36.0 s) and video (34.5 s) than the control (28.0 s) groups. The first attempt success rate decreased in the ST direct (77.5%) but not the video (95.0%) group compared with the control group (100%). Conclusions: The challenges of tracheal intubation in the ST position, aimed at reducing the risk of pulmonary aspiration, can be mitigated by using a video laryngoscope, despite slightly longer intubation times.
摘要：
背景：Sellick和Trendelenburg位置（ST位置）的气管插管可以防止肺吸入，但增加了气管插管的难度。我们比较了使用视频和直接喉镜在ST位置的气管插管与直接喉镜在仰卧嗅探位置的气管插管，以评估整体插管性能。方法：将120例患者随机分为三组：仰卧位直接喉镜（对照组），直接喉镜在ST位置（ST直接），和视频喉镜在ST位置（ST视频）。主要结果是插管时间；次要结果包括首次尝试气管插管成功率，插管困难量表评分,操作者对插管难度的主观评估，并修改了Cormack-Lehane等级。结果：ST直接（36.0s）和视频（34.5s）组的中位插管时间大于对照组（28.0s）。与对照组（100％）相比，ST直接组（77.5％）的首次尝试成功率降低，而视频组（95.0％）的首次尝试成功率降低。结论:ST位气管插管的挑战,旨在降低肺吸入的风险，可以通过使用视频喉镜来缓解，尽管插管时间稍长。
